Treatment Of Genital Warts Research Articles

Evaluation of Intralesional Injection of Combined Furosemide and Digoxin Formula In Genital Warts

Abstract Background External genital warts (EGWs) are benign epidermal growths on the anogenital regions, which can occur in both women and men. They are caused by the human papillomavirus (HPV). More than 90% of cases of anogenital warts are caused by HPV types 6 and 11.There are several different ways to treat genital warts with varying degrees of success. However, till now no definitive treatment has emerged as the ideal standard of care in the treatment of genital warts and this has developed the need for new ways and modalities to help manage genital warts more efficiently. Objective To evaluate and verify efficacy, safety and tolerability of intralesional ionic anti-viral injection of combined furosemide and digoxin in treatment of multiple resistant genital warts. Patients and Methods This study included 30 patients divided into 2 groups, 15 patients each, the study group received intralesional injection of combined digoxin and furosemide, one injection every week for maximum 5 injection sessions (5 weeks). 0.3 ml of combined digoxin and furosemide solution was slowly injected into the base of each wart with maximum 5 warts in the session, and the other group received intralesional saline as a control group. Results Both groups demonstrated insignificant differences regarding all demographic characteristics (age, sex, size of warts before treatment, number of warts before treatment and number of sessions) as well as duration of disease. The treatment used in this study was safe and tolerable with no systemic exposure with regards to the cardiac system (by ECG before and after treatment). Future studies are recommended on larger number of the patients with multiple genital warts. It might be helpful to try increasing the number of treatment sessions, increasing the number of warts treated per session, decreasing the interval between the sessions or increasing the concentration of the active treatment. Conclusion Intralesional injection of combined digoxin and furosemide wasn’t effective intreatment of genital warts.

Expression profile of long noncoding RNAs and comprehensive analysis of lncRNA-cisTF-DGE regulation in condyloma acuminatum

ObjectiveTo identify differentially expressed long noncoding RNAs (lncRNAs) in condyloma acuminatum (CA) and to explore their probable regulatory mechanisms by establishing coexpression networks.MethodsHigh-throughput RNA sequencing was performed to assess genome-wide lncRNA expression in CA and paired adjacent mucosal tissue. The expression of candidate lncRNAs and their target genes in larger CA specimens was validated using real-time quantitative reverse transcriptase polymerase chain reaction (RT‒qPCR). Furthermore, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were used for the functional enrichment analysis of these candidate lncRNAs and differential mRNAs. The coexpressed mRNAs of the candidate lncRNAs, calculated by Pearson’s correlation coefficient, were also analysed using GO and KEGG analysis. In addition, the interactions among differentially expressed lncRNAs (DElncRNAs)-cis-regulatory transcription factors (cisTFs)-differentially expressed genes (DEGs) were analysed and their network was constructed.ResultsA total of 546 lncRNAs and 2553 mRNAs were found to be differentially expressed in CA compared to the paired control. Functional enrichment analysis revealed that the DEGs coexpressed with DElncRNAs were enriched in the terms of cell adhesion and keratinocyte differentiation, and the pathways of ECM-receptor interaction, local adhesion, PI3K/AKT and TGF-ß signaling. We further constructed the network among DElncRNAs-cisTFs-DEGs and found that these 95 DEGs were mainly enriched in GO terms of epithelial development, regulation of transcription or gene expression. Furthermore, the expression of 3 pairs of DElncRNAs and cisTFs, EVX1-AS and HOXA13, HOXA11-AS and EVX1, and DLX6-AS and DLX5, was validated with a larger number of specimens using RT‒qPCR.ConclusionCA has a specific lncRNA profile, and the differentially expressed lncRNAs play regulatory roles in mRNA expression through cis-acting TFs, which provides insight into their regulatory networks. It will be useful to understand the pathogenesis of CA to provide new directions for the prevention, clinical treatment and efficacy evaluation of CA.

Surgical Management of Giant Condyloma Acuminata Involving Vulva, Perineum and Perianal Area

Condyloma acuminata (CA), also known as anogenital warts, are benign proliferative epidermal and/or mucosal lesions usually caused by Human Papilloma Virus (HPV) type 6 and 11. They initially manifest as variable sized and shaped soft papules or plaques on anogenital skin. However, they can grow as a large, bulky, lobulated growth. Lesions are commonly multiple and multifocal, affecting the vulva, perianal, vaginal and cervical regions. They represent the most common sexually transmitted disease (STD) and are highly contagious. Further, the incidence of CA is 5-7fold higher in Human Immunodeficiency virus (HIV) positive patients compared to immunocompetent patients. The HIV infection reduces the local immune control of HPV infection thus favours the proliferation of the HPV which results into large sized CA. The giant condyloma acuminata (GCA) and giant condyloma of Buschke-Löwenstein (GCBL) are uncommon variants of classical condyloma acuminata (CCA) which can reach the size of 10 to 30 cm. The treatment of CA should be individualized and based upon the extent of disease and treatment availability. The small CA which present as papules or plaques can be treated by Podophyllin, Imiquimod, electrosurgical ablation or cryotherapy. However, GCA require excision with cold knife, electrosurgery or CO2 laser. When the base of GCA is narrow, surgical excision with minimal skin loss allows primary closure of the wound, whereas when the base is broad and relatively fixed, one must keep the differential diagnoses of GCA versus GCBL which require wide excision and reconstruction of the tissue. This case report illustrates the surgical management of GCA with broad base in a 44-year-old female patient with HIV infection. She was treated by wide surgical excision followed by reconstruction of the defect with fascio-cutaneous V-Y advancement flaps. Histology confirmed the diagnosis of condyloma acuminatum. Six months following surgery, she had recurrence of a perianal wart that was cauterized. On further 12 month follow up there was no new recurrence of any condylomatous lesion.

Efficacy and safety of topical photodynamic therapy for genital warts: experience review in China

SignificanceHigh recurrence rate and adverse effects were common shortcomings in treatments for genital warts, and the inaccessibility of some deep meatal lesions remains an intractable problem. This study aims to evaluate the treatment of PDT for genital warts in comparison to alternative treatments. ApproachSeven databases and ClinicalTrials. gov were searched and seven randomized controlled trials were finally included. ResultsThere was no significant difference in clearance rate of urethral lesions between the PDT group and the CO2 laser therapy (CO2-LT group) (Odds ratio [OR] 0.676, 95% confidence interval [CI] 0.071–6.426, P = 0.734), but the overall clearance rate of all genital warts was slightly lower for PDT (OR 0.574, CI 0.335–0.985, P = 0.044). The recurrence rate after PDT was significantly lower than after CO2-LT (OR 0.318, CI 0.220–0.460, P < 0.001), and adverse effects were also slighter after PDT (OR 0.015, CI 0.003–0.074, P < 0.001). In addition, a modification of parameters of light irradiation provides the potential to alleviate pain. This study shows that PDT is an effective treatment for genital warts with good tolerability and safety, especially for cavitary lesions. Some modified protocols probably have the potential to reduce adverse effects. ConclusionsIn all, this study demonstrates that PDT is a favorable treatment for genital warts with high efficacy, low recurrence rate and mild adverse effect, especially for urethral and other cavitary lesions. Besides, some modified protocols probably had the potential to reduce adverse effects, but still needed further investigation.

The Combination Therapy of Condyloma Acuminata Patient with Diabetes Mellitus: Case Report

Introduction: Condyloma acuminata with immunocompromised influences the choice of therapy and disease prognosis. This case report aims to provide an overview of the clinical outcome of condyloma acuminata in patients with diabetes mellitus. Case report: Male, 53 years old, with a mass on the penis from the coronary sulcus to the glans penis, lesions resembling cauliflower. An acetowhite and histopathological investigation support the diagnosis of condyloma acuminata. Therapy with trichloroacetic acid (TCA) 90% and zinc sulfate monohydrate55mg/day. The lesions disappeared, and there were no new lesions after 2 weeks of treatment. There was no recurrence after 3 months of follow-up. Discussion: There is no consensus governing the line of therapy for KA. So, there is no one therapy that is definitely ideal for all patients in general. Several previous studies used TCA and oral zinc with various doses and durations of therapy. Conclusion: Giving TCA 90% every week and zinc sulfate monohydrate55mg/day gave satisfactory results in the treatment of condyloma acuminata with diabetes mellitus. Keywords: Condyloma acuminata, diabetes mellitus, therapy

Comparing the Effect of 20% Zinc Oxide Ointment With 80% Trichloroacetic Acid Solution in the Treatment of Genital Warts: A Single-Blind Randomized Clinical Trial

Comparing the Effect of 20% Zinc Oxide Ointment With 80% Trichloroacetic Acid Solution in the Treatment of Genital Warts: A Single-Blind Randomized Clinical Trial

The effectiveness of different immunotherapies in the treatment of condyloma acuminatum: a network meta-analysis of randomized clinical trials.

The treatment of condyloma acuminatum (CA), especially the very persistent and recurrent CA, is currently the focus of our research. Immunotherapies have recently been shown to be well-tolerated and effective in treating warts, particularly refractory warts. However, there is still a lack of corresponding evidence-based medical evidence on the effectiveness of different immunotherapies in treating warts. The difference between network meta-analysis and meta-analysis is that network meta-analysis can be used to compare multiple treatments by combining direct and indirect evidence to assess the interrelationship between all treatments. We intend to compare the efficacy of different treatments for CA using a network meta-analysis. PubMed, Cochrane Library and Embase from inception to June 1st, 2023 were searched using a computer. All articles on immunotherapies for CA were included. Stata MP17.0 software was used for data analyses. A total of 8 randomly-controlled trials involving 493 patients were included. Result showed that all treatment measures had a significant efficacy compared with the regular saline group (BCG (bacillus Calmette-Guérin vaccine) OR = 96.00, 95%CI: 10.35-890.58; MMR (measle, mumps and rubella vaccine) OR = 29.69, 95%CI: 7.47-118.04; Candida antigens OR = 27.34, 95%CI: 8.64-86.52; PPDs (purified protein derivatives) OR = 23.33, 95%CI: 6.75-80.60; VD3 OR = 21.36, 95%CI: 4.34-105.16 and purified protein derivatives (general) OR = 13.14, 95%CI: 3.38-51.12). The area under the curve (SUCRA) ranking results showed that the bacillus Calmette-Guérin vaccine had the highest total efficiency, which was 88.2%, with the rest in the order of measle, mumps and rubella vaccine, which was 68.9%, Candida antigens, which was 63.6%, purified protein derivatives, which was 52.9%, vitamin D3, which was 49.0%, purified protein derivatives (general), which was 27.4%, and saline, which was 0%. In summary, we found that the bacillus Calmette-Guérin vaccine was superior to other treatments in terms of efficacy according to the SUCRA value.

Comparative Study of Intralesional Measles–Mumps–Rubella Vaccine versus Needling-Induced Autoinoculation in the Management of Genital Warts

Abstract Background Genital warts caused by human papillomavirus (HPV) are one of the most common sexually transmitted infections, especially among women. Genital HPV infection has a relatively long incubation period up to 8 months. It is known to have a high recurrence rate, and the infection by certain high-risk HPV strains is known to be associated with malignancies of cervix, penis, vulva, vagina, and anus. Thus, factors such as long latency, lesions’ multiplicity, high recurrence rate, and the tendency to malignant transformation, are essential challenges during management of genital HPV infections. The clinical outcome of traditional treatment modalities; such as podophyllotoxin, imiquimod, cryotherapy, electrocautery, trichloroacetic acid, photodynamic therapy, and laser, is limited to individual lesions. Therefore, they are usually inconvenient for patients with multiple and/or recurrent lesions. Aim of the Work to evaluate the safety and efficacy of intralesional injection of MMR vaccine in comparison with needling-induced autoinoculation in the treatment of genital warts. Patients and Methods Our study included 50 patients with multiple and recurrent genital warts (more than 4 genital warts) divided into two equal matched groups. One group was subjected to MMR injection and the other subjected to needling-induced autoinoculation every two weeks for maximum three sessions. Follow-up was done for 8 weeks after last session. Results This study reports that both treatment options showed statistically significant value in treatment of genital warts, and here was no statistically significant difference between both study groups as regard response to treatment. Conclusion both MMR and needling are simple and effective modalities of immunotherapy for treatment of multiple genital warts with excellent safety profile. The only disadvantage is the long time taken for immune response to occur. Combination treatment plan can overcome this disadvantage. Needling-induced autoinoculation; being more safe and inexpensive, may be considered as a competing immunotherapeutic treatment modality for multiple and recurrent genital warts.

A case report of extensive condyloma acuminata in a pediatric patient clearing with compounded 3% cidofovir gel

BackgroundManagement and treatment of condyloma acuminata in children are often challenging. The mode of transmission is not always traceable and a sexual abuse investigation should be considered. Treatment ranges from no intervention to reconstructive surgery depending on the extent and symptoms.Case presentationWe are reporting a case of an 18-month-old female with extensive symptomatic condyloma acuminata who was able to avoid surgical treatment after treatment with topical cidofovir 3% gel.ConclusionThis patient is being presented to highlight a medical treatment that can be considered in extensive or large condyloma acuminata cases.

The Burden of Genital Warts in Finland: Cross-Sectional Analysis of the Prevalence and Direct Medical Costs in 2018.

Genital warts (GWs) caused by the human papilloma virus (HPV) are a significant health problem due to high prevalence and rate of recurrence. Bivalent vaccine has been used since the start of the national vaccination program in 2013, making it feasible to study the GW burden in Finland. There is no national and up-to-date information available on the prevalence and the burden of GWs in the various healthcare sectors in Finland. The present study investigated the prevalence, healthcare resource use, and direct medical costs of the treatment of GWs in Finland in 2018 using data in national healthcare registers. GW cases were identified based on diagnoses in public healthcare and GW-related prescription medications. Cost analysis included public healthcare contacts, procedures in private care, and medications. The study showed that approximately 12,000 GWs cases were treated in Finland in 2018. Since less than half of GW diagnoses were recorded in public healthcare registers, determining the exact costs was challenging. The estimated direct treatment costs in 2018 were 2.6 M€, which is higher than the previous estimation in Finland, yet still likely an underestimation of the true burden. These results provide information for the management of the GW burden in Finland.

How to differentially detect potentially risky human papilloma virus strains in the human population?

The human papillomavirus (HPV) represents one of the most common sexually transmitted infections, knowing more than 100 viral types that, in relation to their oncological pathogenesis, are classified into types of high and low oncological risk. Cervical cancer is the second leading cause of death from malignant neoplasms in women. HPV can often cause warts. Most types of this virus are harmless, but a percentage of them are associated with an increased risk of cancer. These types are born from the genitals and are acquired through sexual contact with an engaged partner. Cervical cancer is the second leading cause of death from malignant neoplasms in women. HPV infection is responsible for various lesions in different areas of the body. Common warts are the most frequent. They consist of whitish papillomatous lesions that can be in any area, oral mucosa, genital mucosa, etc. Most people infected with the genital human papillomavirus are only carriers. It usually has no symptoms and goes away on its own, without causing serious health problems. There is no cure for HPV, but there are treatments for the health problems that some types of HPV can cause, such as genital warts and cervical cancer. Thanks to cytology and histopathology, it can be detected and treated promptly, reducing the impact of this disease. In addition, there are vaccines that promise to reduce this cancer, especially in countries with the highest number of cases. The virus can remain in the body, even after receiving treatment for genital warts. This means that HPV can still be transmitted to sexual partners, despite not having physical manifestations of it. This work will present the bases for the differential detection between the riskiest HPV strains: HPV-18 and HPV-16 through their detection using the amazing idea of ​​Kary Mullis: Polymerase Chain Reaction.

Effectiveness and safety of topical application of diphenylcyclopropenone versus podophyllin in treatment of genital warts.

Many therapeutic modalities are available for treating genital warts; however, the effectiveness of both diphenylcyclopropenone and podophyllin is still controversial. To evaluate the effectiveness and safety of diphenylcyclopropenone and podophyllin in treating genital warts. This study included 57 patients, divided randomly into two groups. Group (A): diphenylcyclopropenone (n = 29). Group (B): podophyllin 25% (n = 28). In group (A), sensitization was done with 2% diphenylcyclopropenone. Then, after 1 or 2weeks, treatment started with a weekly application of diphenylcyclopropenone solutions ranging between 0.001 and 1% until clearance, or for a maximum of 10 sessions. In group (B), podophyllin 25% was applied weekly until clearance or for a maximum of 6weeks. Higher clearance was achieved in group A, with 19 of 29 (65.5%) patients, than in group B, with 9 of 28 (32.1%) (p-value = 0.004). Also, effectiveness increases with young age in group A. Shorter wart duration was associated with better response in both groups (p-value = 0.005). No serious adverse effects occurred in either group. No recurrence was detected in group A, while seven patients (77.8%) had recurrence in group B after 1year of follow up. Diphenylcyclopropenone shows a higher success rate than podophyllin in treating genital warts and a lower recurrence rate.

A case study of homoeopathic treatment for Genital Warts

A case study of homoeopathic treatment for Genital Warts

Correlation of miR-125b with Treg/Th17 Cell Imbalance in Condyloma Acuminatum and Its Regulation on Autophagy of Keratinocytes.

Condyloma acuminatum (CA), a sexually transmitted disease caused by human papillomavirus (HPV) infection, the present research aims to analyze the mechanism of microRNA-125b (miR-125b) in condyloma acuminatum (CA) and its correlation with Treg/Th17 cell imbalance, the objective is to provide new research ideas for the prevention and treatment of CA in the future. The study population comprised 57 CA patients admitted between April 2020 and June 2022 (observation group, OG) and 64 concurrent healthy controls (control group, CG). The peripheral blood miR-125b and Treg/Th17 cells in all participants were detected to identify the correlation of miR-125b with CA severity and Treg/Th17 cells, and the diagnostic value of miR-125b for CA was analyzed. Then keratinocytes (KCs) from skin lesions of CA patients were isolated. Besides, autophagic proteins LC3-II and Beclin-1 in KCs were measured by Western blotting and immunofluorescence staining. miR-125b expression and Th17 cell percentage were lower in OG than in CG, and reduced gradually with the increase of CA severity, while the Treg cell percentage was higher versus CG and increased as CA worsened (P<0.05). miR-125b exhibited a positive association with Th17 cell percentage and an inverse correlation with Treg cell percentage (P<0.05). ROC analysis identified the excellent diagnostic effect of miR-125b on CA (P<0.05). In vitro, increasing miR-125b decreased the ability of KCs to proliferate, enhanced the apoptosis rate, and elevated LC3-II and Beclin-1 expression (P<0.05). In Conclusion, miR-125b, under-expressed in CA, is closely related to Th17/Treg cell imbalance, the mechanism is related to inhibiting the autophagy of KCs and promoting their abnormal proliferation.

尖锐湿疣的治疗进展

尖锐湿疣的治疗进展

Retracted: Clinical Efficacy of Carbon Dioxide Laser Combined with ALA Photodynamics in the Treatment of Condyloma Acuminatum.

[This retracts the article DOI: 10.1155/2021/7211055.].

Retracted: A Case-Control Study of Photodynamic Therapy Combined with Thymosin in the Treatment of Condyloma Acuminatum in Anal Canal.

[This retracts the article DOI: 10.1155/2022/3019379.].

Topical photodynamic therapy for genital warts: Systematic review and meta‐analysis

AbstractHigh recurrence rate and adverse effects were common shortcomings in treatments for genital warts, but a number of clinical studies have found that photodynamic therapy (PDT) had some unique superiority compared to other treatments. This study aims to evaluate the efficacy and safety of PDT for genital warts in comparison to alternative treatments. Seven databases and ClinicalTrials.gov were searched and seven randomized controlled trials were finally included. There was no significant difference in clearance rate of urethral lesions between the PDT group and the CO2 laser therapy (CO2‐LT group) (Odds ratio [OR] 0.676, 95% confidence interval [CI] 0.071–6.426, P = 0.734), but the overall clearance rate of all genital warts was slightly lower for PDT (OR 0.574, CI 0.335–0.985, P = 0.044). The recurrence rate after PDT was significantly lower than after CO2‐LT (OR 0.318, CI 0.220–0.460, P &lt; 0.001), and adverse effects were also slighter after PDT (OR 0.015, CI 0.003–0.074, P &lt; 0.001). In addition, a modification of parameters of light irradiation provides the potential to alleviate pain. This study shows that PDT is an effective treatment for genital warts with good tolerability and safety, especially for cavitary lesions. Some modified protocols probably have the potential to reduce adverse effects, but still need further investigation.

Photodynamic therapy in the treatment of condyloma acuminata: A systematic review of clinical trials.

Condylomata acuminata (CA) is a sexually transmitted infection with a high prevalence associated with psychosexual morbidity in both men and women of various age. Up to now, treatment modalities yield low clearance and recurrence rate (RR) and are also deemed low quality evidence-wise. Photodynamic therapy (PDT) is a novel and promising therapy to effectively cure and prevent CA recurrence. This systematic review was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and registered to the International Prospective Register of Systematic Review (PROSPERO) (CRD42022332760). Ten studies were included in this systematic review. A significant value of complete response (CR) ranging from 63-100% in patients with genital warts after receiving several sessions of PDT. A relatively low recurrence rate was seen in all 10 studies, with an RR of less than 17%. Quality assessment of included studies reported mostly high-quality research. PDT therapy resulted in a higher CR with significantly lower RR compared to other therapies. Thus, PDT can be an alternative treatment of CA with low RR and minimal side effects. Additional research, especially randomized clinical trials in various countries, is needed to further substantiate this treatment and formulate definitive protocols.

Superficial shaving combined with photodynamic therapy is effective as a treatment for condyloma acuminatum

AbstractCondyloma acuminatum is a common sexually transmitted disease caused by human papillomavirus. Its prevalence and recurrence rates are high. While there are multiple treatment options for condyloma acuminatum, no single therapy form is effective in achieving complete remission. Photodynamic therapy (PDT) was shown to be very promising as a treatment option for condyloma acuminatum. However, for some patients the therapeutic result after a single PDT session is not satisfactory. Thus, it is necessary to develop an effective treatment method for recalcitrant condyloma acuminatum.We hypothesize that suboptimal therapeutic results after a single PDT may be caused by an insufficient penetration of the photosensitizer into the tissue. Here, we applied a combination of superficial shaving and PDT to address this issue. All patients were satisfied with the effect of the treatment, and their quality of life improved significantly. Pain was the major adverse event during treatment but was acceptable to all patients. Therefore, superficial shaving in combination with PDT is safe and effective.